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Sending abortion pills through the mail is timely and effective

May 13, 2024 – Distributing abortion pills through the mail works and also requires patients to pick them up in person at a clinic or doctor’s office, according to new research from UC San Francisco, which comes as the Supreme Court considers whether the abortion pills should be banned Allowed. excercise.

Researchers found that using a mail-order pharmacy to deliver the medications after an in-person assessment was both safe and effective, and patients appreciated the privacy and convenience of receiving their abortion medications that way.

“Any attempt at mitigation is not based on science.” –Daniel Grossman, MD

“The study provides additional evidence that the abortion drug mifepristone should be treated like any other drug and can be easily dispensed by pharmacists, including through a mail-order pharmacy,” said Daniel Grossman, MD, UCSF professor of Obstetrics, Gynecology and Reproductive Sciences and director of the Advancing New Standards in Reproductive Health (ANSIRH) program. “Any attempt to limit this is not based on science.”

The findings were published in the journal on May 13, 2024 JAMA Internal Medicine.

The percentage of abortions performed with medication, often via telemedicine, has grown rapidly in recent years as the Food and Drug Administration (FDA) has updated regulations on how the medications can be provided, and as many states have banned abortion. By 2023, nearly two-thirds of all abortions in the United States were performed with medication.

Sending abortion pills through the mail has only been allowed since the COVID-19 pandemic, when the FDA eliminated the in-person delivery requirement, first temporarily and then, based on evidence of its safety, permanently. Previously, patients had to go to a certified healthcare provider in a doctor’s office, hospital or clinic to receive mifepristone, the first of the two medications used in medication abortion.

However, because most physicians do not keep many medications in their offices, access is hampered by the need to keep mifepristone on hand.

“There is a lot of interest among gynecologists, family medicine physicians, internal medicine physicians and pediatricians to be able to provide this care to their patients who need it,” Grossman said. “This care model using a mail-order pharmacy can help them with that.”

No side effects due to mail order delivery

Researchers analyzed the experiences of 510 people who received mifepristone, which blocks progesterone, a hormone needed to continue pregnancy, and a second drug, misoprostol, used one to two days later to induce labor.

Patients received the drugs in the mail after being seen at abortion and primary care clinics in seven states — California, Colorado, Delaware, Georgia, New York, Pennsylvania and Rhode Island — between January 2020 and May 2022.

Researchers found that nearly 98% of patients had complete abortions and there were no adverse events related to mail-order pharmacy dispensing. More than 85% of participants received the medication within one to three days, a time frame described as reasonable by 94% of participants. And 96.6% said they were satisfied with mail order delivery. Nearly all said their confidentiality was maintained during the shipping and delivery process.

After the Supreme Court ended the constitutional right to abortion in 2022, allowing abortion bans to take effect, anti-abortion groups turned their sights to medication abortion. They sued the FDA to restrict mifepristone, despite extensive research supporting its safety and efficacy.

The case before the Supreme Court asks the justices to uphold a conservative federal appeals court ruling that would roll back FDA regulations requiring mifepristone, which is approved only for use in medication abortion, to be personally delivered to a doctor’s office. clinic or hospital. This case does not involve misoprostol, which is approved for other indications. The Supreme Court heard oral arguments in March but is not expected to make a decision until June.

In addition to making it more difficult for patients receiving in-person abortion care, a ruling that rolls back access to mifepristone would also impact virtual abortion providers, as they would no longer be able to send them through the mail.

In February, UCSF researchers published a study showing that medication abortion can be safely and effectively administered via telemedicine.

Authors: Co-authors from UCSF include Sara Raifman, MSc, Natalie Morris, MPH, Lela Bachrach, MD, Jessica Beaman, MD, Antonia Biggs, PhD, and Eleanor B. Schwarz, MD.

Financing: This study was funded by the Society of Family Planning Research Fund (SFPRF12-MA8).

About ANSIRH: Advancing New Standards in Reproductive Health (ANSIRH), based at the University of California, San Francisco, conducts rigorous scientific research on complex issues related to reproductive health in the United States and internationally. ANSIRH provides much-needed evidence for active policy debates and legal battles around reproductive health issues. For more information, please visit www.ansirh.org.